The costs of flattening the curve

kropotkin1951 wrote:

A24 it seems that it gets a little clearer when you bring it down to the personal level. In BC my grandchildren are returning to school and their parents have been working full time at jobs that don't require interaction with  the public. They have spent their whole lives with at least weekly visits from my mother-in -law, their great grandmother. She has numerous great grandchildren who are tottlers and one set of their parents work at a DND facility.

She is 89, should she presume that COVID is not going to kill her because we have had no cases on the Island for over two weeks? Does the priority now become her great grandchildren's need to interteract with her or should we balance the high risk of death against the low change of contracting the virus and all look to measures that will prevent the potential transmission to her of a virus with an extreme risk of death for her?

That is a very good question, and there is no easy answer to that. I think part of the reason for the stress that we all want easy answers that have certainty in a context where that doesn't exist or what we thought we knew last week turns out to be different today. As for the specific dilema, if I was that old and I had great-grand children, I would probably prefer to be in contact with my family regardless. It's a real quality of life or quantity of life question. The irony is that we were told not to do family gatherings over Easter to protect our elders, when so many of our elders are of advanced age and frailty that Easter 2020 was going to be their last Easter without the pandemic.

kropotkin1951 wrote:

I don't like that kind of logic. An 89 year old can live for a decade and see yet unborn offspring or take a chance on getting a few hugs over the next few months.

That could very well be the case. It's a tough question. There is no easy answer.

kropotkin1951 wrote:

Here are the guidelines we are following in BC. I find them common sense and not draconian, what do you think?

Guidelines I'm fine with, as long as they are clear and that people are free to take whatever level of risk feels comfortable to them. Hard-and-fast rules intended to govern every aspect of our behaviours I have a problem with.

I'm very happy to hear that Dr. Henry has worked hard to earn public support. That increases the amount of respect I have for her.

My biggest problem with the efforts to flatten the curve is that sometimes health officials take an approach where you model if the dots move around and if the dots do social distancing the difference between infection rates. It's good for information, but doesn't always work in the practical sense. We are not dots. We are human beings with biological and emotional needs that dots don't have. In some cases applying a strictly mathematical model doesn't make sense. For example, baseball has been cancelled in New Brunswick, which has tight border controls and where the virus is nearly gone. Or, take church gatherings limited to 50 people. If a congregation is larger than that, what do you do? Can each congregation split up and do multiple different services? If numbers are capped and the doors are shut so people can't come in, how is that a very welcoming environment? Or not even singing in church? Seriously, I think if the chucrh community is that fragile that mere singing is going to spread coronavirus, then we are in much worse shape than we thought, we're all going to get coronavirus anyways, so we might as well enjoy ourselves and sing. Or outright telling people they can't have any physical contact like hugging or shaking hands? Why not simlpy say, "due to the pandemic, we suggest physical contact be limited," and then everyone can decide for themselves what level of contact they are comfortable with. Do you really think that if Bob wants to shake hands and Bill doesn't, that Bob is going to grab Bill's hand and force it anyways? That's ridiculous. Change practices around communion, fine, but let's not go overboard.

There is another aspect that the mathematical models don't cover. Right now all the drop-in spaces for vulnerable people in the poor urban areas are closed. If the pandemic comes back in the fall and winter, are we going to close these spaces again in the name of stopping covid spread? With people forced outside for long periods of time, that's going to mean death in the streets, or other hazards like fires getting out of control as people desparately search for whatever means they have to stay comfortable.

I also take issue with the idea of things having to change long-term once the pandemic is done. Take New Brunswick's recovery plan, for instance. It identifies a green phase that will be triggered once a vaccine is discovered, or other unspecified knowledge of treatment. Why do we have to wait that long in a jurisdiction where the virus is practically eradicated? What if a vaccine doesn't ever come? Does that mean we're going to go years without fun events like summer and winter festivals, concerts, or sporting events? That seems unreasonable to me, and allowing fear to ruin your life. You are far more likely to die driving to or from one of these events than from a disease you picked up from them. Or take gyms, for example. They already had protocols to clean equipment. Does the new normal mean they have to mandate people book their workouts ahead of time to meet low caps, and to dedicate a large part of the work day to cleaning down the area now and forever until the end of time?

I think we have to be realistic about this. Yes, we may have to take steps to protect ourselves while the pandemic is ongoing. Things may change in society as a result. But I think the endless drumbeat about how everything has to change forever and that nothing should ever go back to the way things were before is overkill. Instead, I think society needs to collectively calm down, catch a breath, take a look at where things are now, and then decide where we want to go.

Is the response to covid triggering an even bigger problem in BC?

Quote:

The BC Coroners Service said 170 people died of an illicit drug overdose in May, the highest total ever recorded for a single month in provincial history.

It's also more people than have died from COVID-19 in B.C. all year.

"It's frustrating to see the number of illicit drug deaths go up and to reach a new high ... It's sad to see this many people impacted, losing their lives," said Andy Watson, a spokesperson for the coroners service.

The province said 167 people have died of COVID-19 since B.C.'s first case of the virus was confirmed six months ago. The annual total for overdoses in B.C. was 554 as of May 31.

The article also notes that a public health emergency has also been declared over overdose deaths in BC. But apparently it's okay to allow poor people to overdose, but the second that covid scares the hell out of "respectable" middle-class residents, covid is all of a sudden the only crisis worthy of attention?

As isolation sets in, suicide rates risk rising. In some cases, they have outpaced corona deaths:

Quote:

Northern California experienced more deaths from suicide than deaths due to the novel coronavirus during the peak month of the pandemic, doctors from the western American state said over the weekend.

“The numbers are unprecedented. We've never seen numbers like this, in such a short period of time,” Dr. Mike deBoisblanc at John Muir Medical Center in Walnut Creek, California, told ABC 7 News.

“We've seen a year's worth of suicide attempts in the last four weeks,” he added.

Pondering wrote:

Aristotleded24 wrote:

I mentioned the issue of overdose deaths because of the possibility that the spike is related to the pandemic response. For example, in Winnipeg, any drop-in service for vulnerable people in the urban areas with high poverty, if they aren't closed outright, are very restricted in the services they are offering. Is that the case in BC? Not having drop-in services will have detrimental impacts, whether on mental health which can exacerbate addictions or being able to connect to services through the drop-ins. Are the same restrictions in effect in BC? Is the pandemic response diverting resources away from dealing with the opiods?

This is a perfect example of social distancing=lives saved, no social distancing=lives lost is not that simple. We are very lucky that social distancing in Winnipeg started in mid-March. I truly believe that if it had happened in the middle of winter that people would have frozen to death in the streets due to having nowhere to go during the day. I also believe that health officials would be patting themselves on the back about the wonderful job they were doing stopping deaths from corona while overlooking people freezing in the streets.

You don't know how many lives have been saved due to locking down.  It is no secret that mental health care in Canada is severely lacking. The people who have committed suicide would possibily also commit suicide if their family died of Covid 19 or their place of work was shut down because of a mass breakout.

That's also possible. Human behaviour is very complex, far more so than any mathematical model can account for. That's why it's fallicious to make an absolutist claim that lockdowns "save lives" without considering other factors that are ultimately too complex to ever have a full, accurate picture of the situation.

Let children be children:

Quote:

For parents of young children who are concerned about the risk of COVID-19 infection from surfaces like playgrounds, which have been off limits in cities like Toronto for months, the lack of evidence is no doubt frustrating.

Marr thinks the guidance on children avoiding playgrounds has been "misguided" throughout the pandemic.

"Playgrounds are probably one of the safer places for kids to congregate, if they have to congregate," she said. "And the reason why is that sunlight kills off the virus pretty effectively. So if it is on surfaces, I don't think it's going to last very long."

Chagla said at this point in the pandemic, there's no "good reason" why playgrounds should remain closed, given the combination of sunlight and open-air ventilation making them a relatively low-risk activity.

Marr said the real risk of infection from playgrounds is largely from kids who are in close contact with each other, not from the surfaces they're interacting with.

Howard Njoo, Canada's deputy chief public health officer, said Wednesday that officials are weighing the evidence on infection in children, but that the risk seems low. 

"From the science, what we know is that certainly young people, children, are less likely to have more severe consequences if they do get infected with the virus," he said.

"It also appears that in terms of transmission, young children — at least in some of the studies I've seen — do not appear to be as efficient or effective in terms of transmitting the virus to others."

Here is what happens when children play on the playground. They get vitamin D. They are exposed to all kinds of germs and pathogens from the dirt. They are running around, laughing and having fun with their friends, which reduces stress. All of this helps to build up and strengthen their immune and respiratory systems, which are the exact body systems we need to be strong during a pandemic.

Might this have been an exaggeration from the start?

[quote]

In mid-March, professor Neil Ferguson with the Imperial College of London made a series of projections, including one that predicted upwards of 326,000 Canadians would die as a result of COVID-19 if mitigation measures weren’t put in place. With physical distancing and lockdown measures in place, he predicted that toll could be reduced to 46,000. 

The Canadian economy shut down quickly after these models were released. 

“The problem here is that the actual numbers that have come in have been massively lower than those predictions,” said Peter St-Onge from the MEI. 

As of Thursday, more than 7,600 Canadians have died of COVID-19 – a number well under Ferguson’s best-case scenario. 

...

St-Onge said a blanket shutdown was unnecessary, given the fact that the virus has mostly affected seniors in long-term care facilities. 

“If that’s the case – locking down working age people; waitresses, truck drivers – it completely missed the mark, but meanwhile it causes this massive economic damage,” he said. 

St-Onge predicts that the economic downturn will bring its own set of consequences on health, that may be worse than the virus itself – but Quebec Premier François Legault disagrees. 

“With the information we had at the time… it was important to make sure we put all chances on our side, to not spread too much the virus,” he said.[/quote[

So given what we now know, Legault isn't backing down or open to adjusting his approach, and yet people like me who were treating these claims that we were all going to due unless we locked down with some skepticism (and I would have thought that skepticism of large-scale government interventions that limit people's freedom to move should be the default position until it's proven otherwise) are the extremists in this discussion?

kropotkin1951 wrote:

Aristotleded24 wrote:

Now June was the worst months for overdose deaths in BC history:

Quote:

For the second consecutive month, a record number of illicit drug toxicity deaths have been reported in B.C.

B.C. Coroners Service Chief Coroner Lisa Lapointe said 175 people died in June, which is up from 171 deaths in May.

Prior to May, the worst month on record was December, 2016, when 161 lives were lost.

"We know the COVID-19 pandemic has impacted people who use drugs, as it has all British Columbians," she said.

"Access to key harm reduction services has been a challenge and our social networks are smaller."

Dr. Henry has given the government the answer to the problem and they refuse to listen because Horgan is a moralistic asshole who thinks addicts deserve to die because it is a "choice." The deaths can end almost immediately COVID or no COVID.

If it is John Horgan's fault, then why is Winnipeg also seeing a rise in the number of overdoses in a much similar trend that came about with the social distancing measures enacted? Note in the article that the Mental Health and Addictions Minister claimed a falling fatal oversode rate before the pandemic hit. Remember what I said about the ability to do social distancing being a priviledge? That applies to drug addiction. The social distancing measures have destroyed communities, and many of these people are by themselves, with nothing but all the time and money in the world they need to feed their addictions. The co-founder of a local recovery centre here in Manitoba said that there are more overdose deaths than deaths from corona that he knows of personally. There are probably more. And if, as you claim, Horgan is ignoring Dr. Henry's advice on drug overdoses and following her advice on covid, that proves the point of this thread and what I have been saying for months, which is that we are excessively focused on covid to the point of neglecting not only other causes of death, but are blind to the very real potential harm brought about by these draconian reactions to covid which have placed more restrictions on people's movements for a much longer time frame than should be acceptable to anyone who likes living in a free country.

Not that I wish to defend Brian Pallister, but if Winnipeg and BC are both experiencing a rise in overdoses at roughly the same time, why discount the possibility that perhaps there is a common thread beyond the control of both governments that is driving this thing? Note that the article discussing increased overdoeses in BC talks about a rise in overdoses that happened in May? Note that the article talking about overdoses in Winnipeg talks about rises in calls in April and May? What was happening across the world at this time. Furthermore, as per the CBC article I posted, several people on the front lines of addiction said the following:

Quote:

Manitoba's chief medical examiner's office said it won't have numbers on fatal overdoses during the pandemic until the fall, but 911 call data from the Winnipeg Fire Paramedic Service mirrors what addictions support workers say they've seen on the street.

Emergency calls related to crystal meth and opioid poisonings or overdoses increased 66 per cent in April and May, compared to the same period last year.

...

"We would be naive to say that the COVID world we live in has not increased the demand and desire to cope," paramedic Cory Guest said.

"Some folks are vulnerable, some folks are dealing with trauma.… The No. 1 reason that folks do substances is often to cope."

Manitoba's first COVID-19 cases were detected in the first half of March. Closures soon followed. So did physical distancing.

That created barriers to accessing addictions support services, Rabb said.

People began using substances more in isolation, he said, and that carries a heightened risk when things go wrong.

Sure things like increased shelter capacity and safe and legal supplies of drugs might save lives. But there are a variety of factors related to addicitons, and I would have assumed that if something could be done in the community to reduce the number of people who fall into addictive behaviours in the first place (or conversely to address a factor that is pushing more people into addictive behaviours) then that would have been considered a good thing all around.

Public health is a vastly complex web of things that are interdependent, and that changes in one area can impact another. Pre-covid, I would have thought that this basic point was understood by public health professionals and us here on babble. But now that the media says that covid is the only threat to public health we need to deal with, it is being treated that way to the exclusion of almost everything else.  I feel like I've been hitting a brick wall with this online community the last few months every time I have pointed that out.

With school opening up, I must absolutely speak out against the suspension of high school sports. Sports promotes many good things, like teamwork and exercise. Exercise also strengthens the respiratory system, which is a key system that the coronavirus attacks. Now without sports, what chances are there for exercise? With sports and other recreation areas shut down, will more teenagers turn to drugs and alcohol and become dependent on said substances? Will no sports have an impact on not being active throughout the rest of their lives? Even if sports events between schools have to be cancelled, can't the schools at least provide some opportunities for physical activities for teens to do within their cohorts?

Cost of physical distancing can't be ignored:

Quote:

I have a saying that there are two viruses at work during this pandemic: one is COVID-19 and the other is physical distancing. Both can kill us.

This week, my wife and I celebrate our 53rd wedding anniversary. It is the first time we are doing so without being able to give one another a kiss, a hug or even hold hands. 

Betty and I met 54 years ago and, it would seem, fell in love immediately. Now, she is a resident in a secure dementia unit of a long-term care facility. And while the staff there is absolutely wonderful and has helped facilitate weekly video conferences, that's not the same as truly communicating with Betty the way that works best for her.

Conversation and communication are two radically different events; communication is more than 90 per cent non-verbal and when one is wearing a mask and unable to touch, it is nigh unto impossible. 

I believe there should be procedures introduced, much like those followed by the staff of these facilities, that would allow me to physically interact with my wife. 

...

In long-term care, people are not patients; they are residents. They are not sick; they are moving in — very much like you or I might move into an apartment. It is the role of the staff to help these residents to live happy and active lives for the rest of their days. Quality of life rather than speed of discharge is the key factor.

The staff of the long-term care home is allowed to interact with residents despite coming and going from the building because each of them is willing to keep a change of clean clothes on site and change into these clothes as soon as he or she reports for work. The staff also have a temperature check and respond to a checklist of questions regarding COVID-19 and potential exposure. 

I would absolutely be willing to do exactly the same as the staff if it meant that I could hold my wife's hand while there is a chance she still remembers me.